Neuropathy refers to a generalized disease or malfunctioning of the nerves due to a variety of causes. Nerves are present throughout the body and damage in any location of this system affects the related body part.

What Is neuropathy?
The word is a combination of “neuro” + “pathy” where “neuro” refers to nerve and “pathy” means suffering or feeling. This is a term that is used to describe injury, damage or disease to the nerves. As a result of such damage, there can be several effects – pain, loss of sensation, loss of function or movement, impairment of gland or organ function.

Classification
Neuropathy may be classified according to:

• The number of nerves affected- mononeuropathy, polyneuropathy, mononeuritis multiplex
• Type of nerve fiber that is involved in motor, sensory or autonomic systems
• Damaged or injured nerves can cause compression or inflammation
• Other classifications include cranial neuropathy vs peripheral neuropathy based on whether cranial nerves or peripheral nerves( those outside the brain/spinal cord system) are involved, focal neuropathy where only a single nerve or one single area of the body is involved.
• Terms like distal symmetric neuropathy are used to describe how distant the affected nerves are from the brain and spinal cord (central nervous system).

Symptoms of Neuropathy

• The malfunction of any nerves results in neuropathy.
• The symptoms of neuropathy depend on the type, location and number of nerves involved
• There are two types of neuropathy symptoms: loss of functions and gain of functions.
• Motor symptoms include weakness, tiredness, lack of balance, muscle atrophy, cramps, and muscle twitch
• Sensory symptoms include numbness, tingling, and pain
• In general, the sensory symptoms appear first before motor symptoms that’s why early diagnosis and intervention are crucial
• Autonomic neuropathy symptoms include dryness of the mouth, constipation, difficult urination, lack of balance or dizziness when you stand up, sexual dysfunction, feeling of bloating after meals, nausea, vomiting, blurred vision, intolerance of heat, decreased sweating and hypoglycemia.
• Clumsiness or falls are common when the nerves that control joints are affected
• In peripheral neuropathy, the symptoms begin at the outer extremities and gradually progress towards the center of the body
• Length-dependent peripheral neuropathy presents with symptoms that affect the lower parts of the body and rarely the upper parts. Since the longest nerves end in the legs and feet, the pain and paresthesia (sensation of pins and needles) appear symmetrically and may not progress to the upper regions of the body.
• When there is a loss of sensation in the lower extremities and feet, the symptoms to watch out for are blisters and sores. These get infected and may not be noticed till the infection takes deep root in the tissues and bones. In such cases, amputation of the part or limb becomes necessary to save the person’s life.

Diabetic neuropathy symptoms
Diabetic neuropathy symptoms occur when a person suffers from diabetes. The high blood-glucose level over a prolonged period in the blood damages the nerves throughout the body. However, in most cases, it damages the nerves connected with the legs and feet. There are different types of diabetic neuropathy: peripheral, autonomic, radiculoplexus neuropathy and mononeuropathy.

Typical symptoms

• In peripheral diabetic neuropathy, symptoms usually start at the feet and legs, then the hands and arms. The symptoms tend to get worse at night and recede during the day. They include pain, tingling, numbness loss of sensation, sharp and sudden cramps, weakness of muscles, loss of joint reflexes, joint and bone pain, loss of balance and gait, problems with the feet like ulcers, boils, abscesses, infections, etc. If symptoms are identified early, monitoring and control of blood-sugar are beneficial.
• In autonomic diabetic neuropathy, nerves controlling the heart, bladder, stomach, sexual organs and eyes are affected. Symptoms include increased heart-rate, sexual dysfunction, body-temperature problems, slower/decreased digestion, vision problems etc.
• In radiculoplexus diabetic neuropathy, nerves controlling the thighs, buttocks, hips, and legs are affected. This condition is usually seen in older adults. Symptoms include severe pain in these areas, weakening/shrinking of these muscles, weight-loss, difficulty in sitting/standing.
• In diabetic mononeuropathy, a single nerve is affected, causing focal damage in the face, torso, leg, and eyes. Pain in the area, loss of function and muscle weakness are typical symptoms. Dropping things, carpal tunnel syndrome, Bell’s palsy (paralysis of one side of face) may also be noticed.

When you or your loved ones notice any of the above symptoms, and if you have been diagnosed with diabetes, it’s important to consult your doctor immediately. Diabetic neuropathy symptoms like wounds/ulcers/sores that don’t heal quickly or get infected, especially in the legs and feet, dizziness, changes in sexual, digestive or excretory functions, severe burning, tingling, crawling sensations that affect your ability to work, drive, sleep etc should be reported and treated immediately.